- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.00 / $7.76 / $13.40
| Facility | | $4.00 | $7.76 | $13.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.14 / $3.33 / $4.70
| Professional | | $2.14 | $3.33 | $4.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.70 / $4.70 / $12.22
| Facility | | $4.70 | $4.70 | $12.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.53 / $2.45 / $7.56
| Professional | | $1.53 | $2.45 | $7.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.82 / $4.70 / $4.70
| Facility | | $2.82 | $4.70 | $4.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.43 / $4.70 / $4.70
| Professional | | $3.43 | $4.70 | $4.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.28 / $9.19 / $30.92
| Facility | | $3.28 | $9.19 | $30.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.82 / $4.75 / $25.70
| Professional | | $2.82 | $4.75 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.50 / $6.11 / $332.00
| Facility | | $2.50 | $6.11 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.88 / $2.82 / $8.60
| Professional | | $1.88 | $2.82 | $8.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.05 / $4.38 / $5.28
| Professional | | $3.05 | $4.38 | $5.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.55 / $11.07 / $51.08
| Facility | | $5.55 | $11.07 | $51.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.97 / $4.17 / $7.92
| Professional | | $2.97 | $4.17 | $7.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.12 / $2.82 / $7.05
| Professional | | $2.12 | $2.82 | $7.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.40 / $5.40 / $16.85
| Facility | | $5.40 | $5.40 | $16.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.05 / $4.46 / $5.65
| Professional | | $3.05 | $4.46 | $5.65 |